Chiropractic (1924)

H.L. Mencken

This preposterous quackery flourishes lushIy in the back reaches
of the Republic, and begins to conquer the less civilized folk
of the big cities. As the old-time family doctor dies out in the
country towns, with no competent successor willing to take over
his dismal business, he is followed by some hearty blacksmith
or ice-wagon driver, turned into a chiropractor in six months,
often by correspondence. In Los Angeles the Damned, there are
probably more chiropractors than actual physicians, and they are
far more generally esteemed. Proceeding from the Ambassador Hotel
to the heart of the town, along Wilshire boulevard, one passes
scores of their gaudy signs; there are even chiropractic "hospitals."
The Mormons who pour in from the prairies and deserts, most of
them ailing, patronize these "hospitals" copiously,
and give to the chiropractic pathology the same high respect that
they accord to the theology of the town sorcerers. That pathology
is grounded upon the doctrine that all human ills are caused by
pressure of misplaced vertebrae upon the nerves which come out
of the spinal cord -- in other words, that every disease is the
result of a pinch. This, plainly enough, is buncombe. The chiropractic
therapeutics rest upon the doctrine that the way to get rid of
such pinches is to climb upon a table and submit to a heroic pummeling
by a retired piano-mover. This, obviously, is buncombe doubly
damned.

Both doctrines were launched upon the world by an old quack
named Andrew T. Still, the father of osteopathy. For years the
osteopaths merchanted them, and made money at the trade. But as
they grew opulent they grew ambitious, i.e., they began to study
anatomy and physiology. The result was a gradual abandonment of
Papa Still's ideas. The high-toned osteopath of today is a sort
of eclectic. He tries anything that promises to work, from tonsillectomy
to the x-rays. With four years' training behind him, he probably
knows more anatomy than the average graduate of the Johns Hopkins
Medical School, or at all events, more osteology. Thus enlightened,
he seldom has much to say about pinched nerves in the back. But
as he abandoned the Still revelation it was seized by the chiropractors,
led by another quack, one Palmer. This Palmer grabbed the pinched
nerve nonsense and began teaching it to ambitious farm-hands and
out-at-elbow Baptist preachers in a few easy lessons. Today the
backwoods swarm with chiropractors, and in most States they have
been able to exert enough pressure on the rural politicians to
get themselves licensed. [It is not altogether a matter of pressure.
Large numbers of rustic legislators are themselves believers in
chiropractic. So are many members of Congress.] Any lout with
strong hands and arms is perfectly equipped to become a chiropractor.
No education beyond the elements is necessary. The takings are
often high, and so the profession has attracted thousands of recruits
-- retired baseball players, work-weary plumbers, truck-drivers,
longshoremen, bogus dentists, dubious preachers, cashiered school
superintendents. Now and then a quack of some other school --
say homeopathy -- plunges into it. Hundreds of promising students
come from the intellectual ranks of hospital orderlies.

Such quackeries suck in the botched, and help them on to bliss
eternal. When these botched fall into the hands of competent medical
men they are very likely to be patched up and turned loose upon
the world, to beget their kind. But massaged along the backbone
to cure their lues [syphylis], they quickly pass into the last
stages, and so their pathogenic heritage perishes with them. What
is too often forgotten is that nature obviously intends the botched
to die, and that every interference with that benign process is
full of dangers. That the labors of quacks tend to propagate epidemics
and so menace the lives of all of us, as is alleged by their medical
opponents -- this I doubt. The fact is that most infectious diseases
of any seriousness throw out such alarming symptoms and so quickly
that no sane chiropractor is likely to monkey with them. Seeing
his patient breaking out in pustules, or choking, or falling into
a stupor, he takes to the woods at once, and leaves the business
to the nearest medical man. His trade is mainly with ambulant
patients; they must come to his studio for treatment. Most of
them have lingering diseases; they tour all the neighborhood doctors
before they reach him. His treatment, being nonsensical, is in
accord with the divine plan. It is seldom, perhaps, that he actually
kills a patient, but at all events he keeps any a worthy soul
from getting well.

The osteopaths, I fear, are finding this new competition serious
and unpleasant. As I have said, it was their Hippocrates, the
late Dr. Still, who invented all of the thrusts, lunges, yanks,
hooks and bounces that the lowly chiropractors now employ with
such vast effect, and for years the osteopaths had a monopoly
of them. But when they began to grow scientific and ambitious
their course of training was lengthened until it took in all sorts
of tricks and dodges borrowed from the regular doctors, or resurrection
men, including the plucking of tonsils, adenoids and appendices,
the use of the stomach-pump, and even some of the legerdemain
of psychiatry. They now harry their students furiously, and turn
them out ready for anything from growing hair on a bald head to
frying a patient with the x-rays. All this new striving, of course,
quickly brought its inevitable penalties. The osteopathic graduate,
having sweated so long, was no longer willing to take a case of
delirium tremens for $2, and in consequence he lost patients.
Worse, very few aspirants could make the long grade. The essence
of osteopathy itself could be grasped by any lively farmhand or
night watchman in a few weeks, but the borrowed magic baffled
him. Confronted by the phenomenon of gastrulation, or by the curious
behavior of heart muscle, or by any of the current theories of
immunity, he commonly took refuge, like his brother of the orthodox
faculty, in a gulp of laboratory alcohol, or fled the premises
altogether. Thus he was lost to osteopathic science, and the chiropractors
took him in; nay, they welcomed him. He was their meat. Borrowing
that primitive part of osteopathy which was comprehensible to
the meanest understanding, they threw the rest overboard, at the
same time denouncing it as a sorcery invented by the Medical Trust.
Thus they gathered in the garage mechanics, ash-men and decayed
welterweights, and the land began to fill with their graduates.
Now there is a chiropractor at every crossroads.

I repeat that it eases and soothes me to see them so prosperous,
for they counteract the evil work of the so-called science of
public hygiene, which now seeks to make imbeciles immortal. If
a man, being ill of a pus appendix, resorts to a shaved and fumigated
longshoreman to have it disposed of, and submits willingly to
a treatment involving balancing him on McBurney's spot and playing
on his vertebra as on a concertina, then I am willing, for one,
to believe that he is badly wanted in Heaven. And if that same
man, having achieved lawfully a lovely babe, hires a blacksmith
to cure its diphtheria by pulling its neck, then I do not resist
the divine will that there shall be one less radio fan later on.
In such matters, I am convinced, the laws of nature are far better
guides than the fiats and machinations of medical busybodies.
If the latter gentlemen had their way, death, save at the hands
of hangmen, policemen and other such legalized assassins, would
be abolished altogether, and the present differential in favor
of the enlightened would disappear. I can't convince myself that
would work any good to the world. On the contrary, it seems to
me that the current coddling of the half-witted should be stopped
before it goes too far if, indeed, it has not gone too far already.
To that end nothing operates more cheaply and effectively than
the prosperity of quacks. Every time a bottle of cancer oil goes
through the mails Homo americanus is improved to that extent.
And every time a chiropractor spits on his hands and proceeds
to treat a gastric ulcer by stretching the backbone the same high
end is achieved.

But chiropractic, of course, is not perfect. It has superb
potentialities, but only too often they are not converted into
concrete cadavers. The hygienists rescue many of its foreordained
customers, and, turning them over to agents of the Medical Trust,
maintained at the public expense, get them cured. Moreover, chiropractic
itself is not certainly fatal: even an Iowan with diabetes may
survive its embraces. Yet worse, I have a suspicion that it sometimes
actually cures. For all I know (or any orthodox pathologist seems
to know) it may be true that certain malaises are caused by the
pressure of vagrant vertebra upon the spinal nerves. And it may
be true that a hearty ex-boilermaker, by a vigorous yanking and
kneading, may be able to relieve that pressure. What is needed
is a scientific inquiry into the matter, under rigid test conditions,
by a committee of men learned in the architecture and plumbing
of the body, and of a high and incorruptible sagacity. Let a thousand
patients be selected, let a gang of selected chiropractors examine
their backbones and determine what is the matter with them, and
then let these diagnoses be checked up by the exact methods of
scientific medicine. Then let the same chiropractors essay to
cure the patients whose maladies have been determined. My guess
is that the chiropractors' errors in diagnosis will run to at
least 95% and that their failures in treatment will push 99%.
But I am willing to be convinced.

Where is there is such a committee to be found? I undertake
to nominate it at ten minutes' notice. The land swarms with men
competent in anatomy and pathology, and yet not engaged as doctors.
There are thousands of hospitals, with endless clinical material.
I offer to supply the committee with cigars and music during the
test. I offer, further, to supply both the committee and the chiropractors
with sound wet goods. I offer, finally, to give a bawdy banquet
to the whole Medical Trust at the conclusion of the proceedings.

_______________________

Henry Louis Mencken (1880-1956) was a controversial American
journalist, essayist and literary critic. During the 1920s, he
became famous for his vitriolic attacks on what he considered
to be the hypocrisy, stupidity, and bigotry of much of American
life. For obvious reasons, his critics considered him highly skilled
at satire but intolerant and often crude. This essay was published
in the Baltimore Evening Sun in December 1924. Although the medical
knowledge of his day was still quite primitive, Mencken knew enough
to realize that chiropractic theory was preposterous.